Patients with uncomplicated diabetes are generally managed on an outpatient basis, but those experiencing complications such as diabetic ketoacidosis will require initial in-hospital stabilization. Cats will require frequent injections of a short acting insulin around the clock to slowly control the blood glucose. These injections are given through a continuous intravenous drip system, by injections in the muscle or in the subcutaneous tissue. The route and frequency of administration will be dependent upon the severity of the pet's clinical signs. Many pets require 24 hour care and may need to be transferred to a 24 referral facility. Longer acting insulin is instituted once the ketones are resolved and the glucose levels have normalized.
In-hospital therapy generally includes insulin administration with frequent dose adjustment, intravenous fluids, administration of electrolytes (blood chemicals), treatment of secondary problems, and antibiotics.
Treatments may include the following:
Fluid therapy is essential. Insulin is generally started after a few hours of fluid therapy. Fluids may be supplemented with electrolytes such as potassium, phosphorus, and/or magnesium. Eventually, dextrose administration (a form of glucose) is often administered after the glucose has normalized yet ketones are still present.
Complications like urinary tract infections may require additional medications, but certain drugs, including steroids (such as prednisone), should be avoided in diabetic cats.
Frequent monitoring of blood glucose, urine ketones, electrolytes, and urine output will help guide above therapy.
Home Care and Prevention
Long term management of diabetes will include insulin injections at home and possible antibiotics to treat infectious complications. Ovariohysterectomy (spaying) is indicated in female diabetic animals. When animals come into heat (estrus), the hormonal changes alter insulin and glucose metabolism.
Be prepared for frequent adjustments to therapy early in the course of treatment. Veterinarians prefer to start with a low dose of insulin initially and adjust upwards slowly to avoid overdose.
For more information for long term home care of diabetic cats, go to Diabetes Mellitus in Cats.
The prognosis depends upon the severity of the illness, the cat's response to therapy, overall heath of your cat, concurrent diseases, and secondary complications from diabetes. Once pets survive the life-threatening DKA portion of the disease and go on to become "routine" diabetics and do well after 6 months of treatment, many will have a good quality of life for more than 5 years.